Does Mirror Therapy vs. Sham Therapy or No additional therapy combined with a traditional neurorehabilitation program improve functional outcomes in adult patients with a CVA?

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Does Mirror Therapy vs. Sham Therapy or No additional therapy combined with a traditional neurorehabilitation program improve functional outcomes in adult patients with a CVA?

Author(s)

Trout, Christopher

Abstract

Background/Purpose: The purpose of this paper was to determine if Mirror Therapy, as an adjunct therapy to conventional neurorehabilitation, helps improve motor recovery and function better than sham therapy or no therapy in patients following a stroke.
Case Description: Mr. G was a 51 year old male who was seen at Lovelace Rehabilitation Hospital on 10/29/13 in Albuquerque, NM after being medically treated at UNMH for a right subarachnoid hemorrhage followed by a hematoma. The patient presented with severe left sided weakness, dysphagia, and aphasia. Physical therapy interventions included mobility training, transfer training, gait training, balance/coordination training, and neuromuscular reeducation.
Outcomes: Mr. G was able to meet most of his long term goals before being discharged to a skilled nursing facility (SNF) on 11/19/13. These goals included minimal assist for bed mobility, contact guard assist/minimal assist for basic transfers, ambulation with a forward wheeled walker to 150 feet before fatigue. Mr. G needed minimal supervision for his home exercise program with assist for right lower extremity and trunk, minimal assist for basic transfers, and minimal assist for sit to stands. His functional independence measure (FIM) score improved from a 33 to 45.
Discussion: Research has shown that mirror therapy can speed up motor recovery and function in patients with subacute stroke. Patients with an acute or chronic stroke did not seem to benefit from mirror therapy. Current studies have focused on the upper extremities more than the lower extremities, although studies are currently being performed on the lower extremities. Mirror therapy is inexpensive, easy to implement, and a patient specific treatment. More high quality studies with longer follow-up periods, brain imaging, and larger population sizes need to be performed in order to determine the long term effects of mirror therapy.